Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-26T03:06:28.321Z Has data issue: false hasContentIssue false

10 - Post-treatment surveillance of renal cancer

Published online by Cambridge University Press:  08 August 2009

By
Parvati Ramchandani
Edited by
Uday Patel
Parvati Ramchandani
Affiliation:
Department of Radiology, University of Pennsylvania, Medical Centre, Philadelphia, USA
Uday Patel
Affiliation:
St George's Hospital, London
Get access

Summary

Introduction

If salvage surgery or immunotherapy is to be offered in a timely fashion for recurrent renal cancer, surveillance after treatment is important to ensure early detection of recurrence, although improved survival with such an approach has yet to be proven. Suggested surveillance protocols have been published to follow patients with treated renal cell carcinoma (RCC). However, in practice, there is little consensus on appropriate surveillance protocols amongst practicing urologists and a recent study documented that published guidelines are often not used with any consistency. This chapter is a review of the clinical features of recurrent disease and how they influence chosen surveillance methods and protocols.

Likelihood of recurrent renal cancer

Approximately a third of the patients who present with localized RCC will develop a local or distant recurrence after therapy. Higher T-stage tumors are associated with increased risk of tumor recurrence. Lam et al. recently reported that overall distant recurrence rate at 5 years after surgical resection was 27.6% for localized disease and 64% for node positive disease. Five-year recurrence-free rate after nephrectomy in patients stratified into a low risk group was 90.4%, intermediate risk group was 61.8%, and high risk group was 41.9%. Median time to recurrence was 28.9 months, 17.8 months, and 9.5 months in the low risk, intermediate risk, and high risk groups respectively.

Type
Chapter
Information
Carcinoma of the Kidney , pp. 185 - 202
Publisher: Cambridge University Press
Print publication year: 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Mickisch, G., Carballido, J., and Hellsten, S., European Association of Urology guidelines on renal cell cancer. Eur Urol, 40 (2001), 252–5. Uroweb 2002, www.uroweb.orgCrossRefGoogle ScholarPubMed
B. Ljungberg, D. C. Hanbury, M. A. Kuczyk et al., Guidelines on renal cell carcinoma. European Association of Urology Update, March 2007. http://berlin.uroweb.org/fileadmin/user_upload/Guidelines/08_Renal Cell Carcinoma 2007.pdf.
Levy, D. A., Slaton, J. W., Sanson, D. A.et al., Stage specific guidelines for surveillance after radical nephrectomy for local renal cell carcinoma. J Urol, 159 (1998), 1163–7.CrossRefGoogle ScholarPubMed
Janzen, N. K., Kim, H. L., Figlin, R. A.et al., Surveillance after radical or partial nephrectomy for localized renal cell carcinoma and management of recurrent disease. Urol Clin North Am, 30 (2003), 843–52.CrossRefGoogle ScholarPubMed
Basu, S., Biyani, C. S., Sundaram, S. K.et al., A survey of follow-up practices of urologists across Britain and Ireland following nephrectomy for renal cell carcinoma. Clin Rad, 61 (2006), 854–60.CrossRefGoogle ScholarPubMed
Patel, U. and Guest, P., Commentary. A survey of follow-up practices of urologists across Britain and Ireland following nephrectomy for renal cell carcinoma. Clin Rad, 61 (2006), 861–2.CrossRefGoogle Scholar
Lam, J. S., Shvarts, O., Leppert, J. T.et al., Postoperative surveillance protocol for patients with localized and locally advanced renal cell carcinoma based on a validated prognostic nomogram and risk group stratification system. J Urol, 174 (2005), 466–72.CrossRefGoogle ScholarPubMed
Stephenson, A. J., Chetner, M. P., Rourke, K.et al., Guidelines for the surveillance of localized renal cell carcinoma based on the patterns of relapse after nephrectomy. J Urol, 172 (2004), 58–62.CrossRefGoogle ScholarPubMed
Leibovich, B. C., Blute, M. L., Cheville, J. C.et al., Prediction of progression after radical nephrectomy for patients with clear cell renal cell carcinoma: a stratification tool for prospective clinical trials. Cancer, 97:7 (2003). 1663–71.CrossRefGoogle ScholarPubMed
Marhall, F. F, Nomograms for renal cell carcinoma. BJU Int, 95:2 Suppl (2005), 14–15.CrossRefGoogle Scholar
S. C. Campbell, A. C. Novick, and R. M. Bukowski, Renal tumours. In: Wein, A. J., Kavoussi, L. R., Novick, A. C., Partin, A. W., Peters, C. A., eds., Campbell-Walsh Urology, 9th edn (Philadelphia, Saunders: Elsevier, 2007), pp. 1604–6.Google Scholar
S. C. Campbell, A. C. Novick, and R. M. Bukowski, Renal tumours. In: Wein, A. J., Kavoussi, L. R., Novick, A. C., Partin, A. W., Peters, C. A., eds., Campbell-Walsh Urology, 9th edn (Philadelphia, Saunders: Elsevier, 2007), pp. 1595–7.Google Scholar
Sorbellini, M., Kattan, M. W., Snyder, M. E.et al., A postoperative prognostic nomogram predicting recurrence for patients with conventional clear cell renal cell carcinoma. J Urol, 173:1 (2005), 48–51.CrossRefGoogle ScholarPubMed
S. C. Campbell, A. C. Novick, and R. M. Bukowski. Renal tumours. In: Wein, A. J., Kavoussi, L. R., Novick, A. C., Partin, A. W., Peters, C. A., eds., Campbell-Walsh Urology, 9th edn (Philadelphia, Saunders Elsevier, 2007), pp. 1611–13.Google Scholar
Chae, E. J., Kim, A. K., Ki, S. H.et al., Renal cell carcinoma: analysis of postoperative recurrence patterns. Radiology, 234 (2005), 189–96.CrossRefGoogle ScholarPubMed
Hafez, K. S., Novick, A. C., and Campbell, S. C., Patterns of tumour recurrence and guidelines for follow up after nephron sparing surgery for sporadic renal cell carcinoma. J Urol, 157 (1997), 2067–70.CrossRefGoogle ScholarPubMed
Kavolius, J. P., Mastorakos, D. P., Pavlovich, C.et al., Resection of metastatic renal cell carcinoma. J Clinical Oncology, 16:6 (1998), 2261–6.CrossRefGoogle ScholarPubMed
Ljungberg, B., Alamdari, F. I., Rasmuson, T.et al., Follow-up guidelines for nonmetastatic renal cell carcinoma based on the occurrence of metastases after radical nephrectomy. BJU Int, 84 (1999), 405–11.CrossRefGoogle ScholarPubMed
Sandock, D. S., Seftel, A. D., Resnick, M. I., A new protocol for the followup of renal cell carcinoma based on pathologic stage. J Urol, 154 (1995), 28–31.CrossRefGoogle Scholar
Banner, B. F., Brancazio, L., Bahnson, R. R.et al., DNA analysis of multiple synchronous renal cell carcinomas. Cancer, 66 (1990), 2180–5.3.0.CO;2-I>CrossRefGoogle ScholarPubMed
Itano, N. B., Blute, M. L., Spotts, B.et al., Outcome of isolated renal cell carcinoma fossa recurrence after nephrectomy. J Urol, 164 (2000), 322–5.CrossRefGoogle ScholarPubMed
Hafez, K. S., Fergany, A. F., Novick, A. C., Nephron sparing surgery for localized renal cell carcinoma: impact of tumour size on patient survival, tumour recurrence and TNM staging. J Urol, 162:6 (1999), 1930–3.CrossRefGoogle ScholarPubMed
Herr, H. W., Partial nephrectomy for unilateral renal carcinoma and a normal contralateral kidney: 10-year followup. J Urol., 161:(1) (1999), 33–4; discussion 34–5.CrossRefGoogle Scholar
Ramchandani, P., Coleman, B. G., Pollack, H. M.et al., CT evaluation after radical nephrectomy for renal cell cancer. Radiology, 181 (1991), 125.Google Scholar
Alter, A. J., Uehling, D. T., Zwiebel, W. J., Computed tomography of the retroperitoneum following nephrectomy. Radiology, 133 (1979), 663–8.CrossRefGoogle ScholarPubMed
Bernardino, M. E., deSantos, L. A., Johnson, D. E.et al., Computed tomography in the evaluation of post-nephrectomy patients. Radiology, 130 (1979), 183–7.CrossRefGoogle ScholarPubMed
Sutherland, S. E., Resnick, M. I. Maclennanet al., Does the size of the surgical margin in partial nephrectomy for renal cell cancer really matter. J Urol, 167 (2002), 61–4.CrossRefGoogle ScholarPubMed
Kubinski, D. J., Clark, P. E., Assimos, D. G.et al., Utility of frozen section analysis of resection margins during partial nephrectomy. Urology, 64 (2004) 31–4.CrossRefGoogle ScholarPubMed
Rassweiler, J. J., Abbou, C., Janetschek, G.et al., Laparoscopic partial nephrectomy: the European experience. Urol Clin North Am, 27 (2000), 721–36.CrossRefGoogle ScholarPubMed
Gill, I. S., Desai, M. M., Kaouk, J. H.et al., Laparoscopic partial nephrectomy for renal tumour: duplicating open surgical techniques. J Urol, 167 (2002), 469–75.CrossRefGoogle ScholarPubMed
Gill, I. S., Matin, S. F., Desai, M. M., et al., Comparative analysis of laparoscopic versus open partial nephrectomy for renal tumours in 200 patients. J Urol, 170:1 (2003), 64–8.CrossRefGoogle ScholarPubMed
Israel, G. M., Hecht, E., and Bosniak, M. A., CT and MR imaging of complications of partial nephrectomy. Radiographics, 26 (2006), 1419.CrossRefGoogle Scholar
Sandrasegaran, K., Lall, C., Rajesh, A.et al., Distinguishing Gelatin Bioabsorbable Sponge and Postoperative Abdominal Abscess on CT. AJR Am J Roentegenol, 184 (2005), 475–80.CrossRefGoogle ScholarPubMed
Gervais, D. A., McGovern, F. J., Arellano, R. S.et al., Renal Cell Carcinoma: Clinical Experience and Technical Success with Radio-frequency Ablation of 42 Tumours. Radiology, 226 (2003), 417–24.CrossRefGoogle Scholar
Atwell, T. D., Farrell, M. A., Callstrom, M. R.et al., Percutaneous Cryoablation of 40 Solid Renal Tumours with US Guidance and CT Monitoring: Initial Experience. Radiology, 243 (2007), 276–83.CrossRefGoogle ScholarPubMed
Silverman, S. G., Tuncali, K., vanSonnenberg, E.et al., Renal Tumours: MR Imaging-guided Percutaneous Cryotherapy – Initial Experience in 23 Patients. Radiology, 236 (2005), 716–24.CrossRefGoogle ScholarPubMed
Wile, G. E., Leyendecker, J. R., Krehbiel, K. A.et al., CT and MR Imaging after Imaging-guided Thermal Ablation of Renal Neoplasms. Radiographics, 27 (2007), 325–39.CrossRefGoogle Scholar
McDougal, W. S., Gervais, D. A., McGovern, F. J.et al., Long-term followup of patients with renal cell carcinoma treated with radio frequency ablation with curative intent. J Urol, 174 (2005), 61–3.CrossRefGoogle ScholarPubMed
Varkarakis, I. M., Allaf, M. E., Inagaki, T.et al., Radiofrequency ablation of renal masses: results at a 2-year mean followup. J Urol, 174:2 (2005), 456–60; discussion 460.CrossRefGoogle Scholar
Gervais, D. A., McGovern, F. J., Arellano, R. S.et al., Radiofrequency ablation of renal cell carcinoma: Part 1. Indications, results, and role in patient management over a 6-year period and ablation of 100 tumours. AJR Am J Roentgenol, 185 (2005), 64–71.CrossRefGoogle Scholar
Gill, I. S., Remer, E. M., Hasan, W. A.et al., Renal cryoablation: outcome at 3 years. J Urol, 173 (2005), 1903–7.CrossRefGoogle ScholarPubMed
Kawamoto, S., Permpongkosol, S., Bluemke, D. A.et al., Sequential changes after radiofrequency ablation and cryoablation of renal neoplasms: role of CT and MR imaging. Radiographics, 27 (2007), 343–55.CrossRefGoogle ScholarPubMed
Matsumoto, E. D., Watumumull, L., Johnson, D. B.et al., The radiographic evolution of radiofrequency ablated renal tumours. J Urol, 172 (2004), 45–8.CrossRefGoogle Scholar
Merkle, E. M., Nour, S. G., and Lewin, J. S., MR imaging follow-up after percutaneous radiofrequency ablation of renal cell carcinoma: findings in 18 patients during first 6 months. Radiology, 235 (2005), 1065–71.CrossRefGoogle ScholarPubMed
Hegarty, N. J., Gill, I. S., Desai, M. M.et al., Probe-ablative nephron-sparing surgery: cryoablation versus radiofrequency ablation. Urology, 68:1 Suppl (2006), 7–13.CrossRefGoogle ScholarPubMed
Atwell, T. D., Invited commentary. Radiographics, 27 (2007), 339–41.CrossRefGoogle Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×